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Cat health
Feline lower urinary tract disease: looking beyond the bladder

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TOO many feline uroliths are being surgically removed and the surgical removal of struvite stones should be regarded as unethical.

That was the view expressed by Jody Lulich, of the University of Minnesota, during a two-day international symposium on feline lower urinary tract health, organised by Hill's Pet Nutrition in Prague in May. The symposium, which brought together 130 vets from around the world, made clear that there is still much to learn about feline lower urinary tract disease (FLUTD), not least because, with most cases being diagnosed as feline idiopathic cystitis (FIC), the cause is more often than not unknown. It also highlighted the importance of taking a holistic approach to investigation and management.

Explaining that an ultimate goal of his centre in Minnesota would be to make surgical removal of feline uroliths obsolete, and suggesting that, in the future, clients might no longer accept it, Professor Lulich argued that, as far struvite stones were concerned, nutritional dissolution was a much better choice. Meanwhile, in the case of oxalate and other stones that were not amenable to nutritional management, other non-surgical options were available. For female cats with small uroliths, these included the technique of voiding hydropropulsion, in which the anaesthetised cat is held vertically and stones are voided with the urine by applying steady manual pressure on the bladder, or basket removal during cytoscopic examination of the bladder. Another technique that could be used in female cats was laser lithotripsy. Determining the need for urolith removal and effective therapies depended on the effects of the urolith on the patient, the physical characteristics of the urolith, what equipment was available and the experience of the veterinarian. However, with additional training and newer technologies, surgical removal of uroliths was becoming less desirable …

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